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SCHOOL TEAMSJOIN THE FUN

10K, 5K RUN AND 2K WALK

Be there for the 11th annual 10K/5K Run and 2K Walk

for all ages. Don your St. Patty's Day attire as there will beawards for the most innovative outfit, greenest garb and best leprechaun!Chip timing system will be provided by Elite Feet. Register early to beguaranteed a T-shirt.

DATE:

Saturday, March 16, 2013

TIME:

Race begins at 9:00 AM - Participants should be at the start line by 8:50 AM

LOCATION:Race begins and ends outside the 3rd Street entrance of the YMCA

FEES:School Group - $15 per personStudents and Coaches Only

YMCA OF THE BLUE WATER AREAYMCA OF THE BLUE WATER AREAYMCA OF THE BLUE WATER AREAYMCA OF THE BLUE WATER AREA1525 3rd Street, Port Huron MI 48060(810) 987-6400 Fax: (810) 987-7251www.bluewaterymca.com

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Please Select Shirt Size:

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Adult X-Large

Adult XX-Large

2013 LEPRECHAUN LOOPSCHOOL TEAM ENTRY FORM

School Group - $15 per personStudents and Coaches OnlyRegistrations ATTN: Community Engagement

Early registrants (registered before February 28) can pick up their shirts and bibs March 15.Otherwise, shirts will be available for pick-up the day of the race. Please remember to allowtime for chip pick-up the morning of the race. Written directions and route map will beavailable at the Y and at www.bluewaterymca.com.

_____________________________________________________________________________ MALE FEMALEName

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Address

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City Zip

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Phone D.O.B. Age

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Email Address School (if applicable)

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Emergency Contact Phone

PARTICIPATION WAIVERPARTICIPATION WAIVERPARTICIPATION WAIVERPARTICIPATION WAIVERI hereby state that I have conditioned myself to participate in the YMCAs Leprechaun Loop Run/Walk. I for myself, my heirs,and the administration waive and release all rights and claims for damages I may have against the YMCA of the Blue WaterArea, its officials, the sponsors, and the City of Port Huron for any and all injuries suffered by me during the YMCAs Run/Walk. Including any and all injuries, which may arise out of travel to, participating in, and returning from the YMCAs Run/Walk. I give permission for my picture to be taken and used in YMCA promotional materials.

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Signature Date

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Parent/Guardian Signature if participant is under 18

Bib Number

Race 10K Run 5K Run 2K Walk